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Biomedical subjects

E Tala

Publications and source records attributed to E Tala.

At least 19 recordsLinked to original sources
PubMed1998

Clodronate is effective in preventing corticosteroid-induced bone loss among asthmatic patients.

Clodronate is a novel drug used for inhibiting osteoclastic activity. The aim of the present double-blind study was to evaluate the efficacy and tolerability of clodronate (Leiras, Finland) in corticosteroid-induced bone loss among asthmatic patients. Seventy-four adult patients (41 women and 33 men, mean age 57.3 years) having a long history (mean 8.1 years) of oral and inhaled corticosteroid therapy were randomized to four parallel treatment groups: clodronate 800, 1600, or 2400 mg/day, or an identical placebo. The bone mineral density (BMD) of the lumbar spine (L2-4), femoral neck, and trochanter were assessed using dual-energy X-ray absortiometry at entry, 6 months, and 12 months. The baseline BMDs did not differ significantly between the study groups. In the lumbar spine, the mean BMD increased significantly between the baseline and 12-month visit in the clodronate groups of 1600 and 2400 mg/day, 2.6% (0.02 g/cm2, p < 0.02) and 3.0% (0.03 g/cm2, p < 0.01), respectively, but not in the placebo and clodronate 800 mg/day groups. The test for a linear trend (BMD percent change for L2-4) at 12 months was significant (p < 0.02), indicating a dose response to clodronate. The mean BMD values of the femoral neck increased significantly in the 2400 mg/day group, 4.3% (0.03 g/cm2, p < 0.0001), as well as in the trochanter region 2.8% (0.02 g/cm2, p < 0.02). Gastric irritation was the most common adverse effect noted on a clodronate dose of 2400 mg/day. We conclude that oral clodronate is effective in preventing bone loss or increasing bone mass in asthmatic patients having a long history of continuous peroral and inhaled corticosteroid administration.

Absorptiometry, Photon↗
PubMed1996

Alpha-Tocopherol and beta-carotene supplements and lung cancer incidence in the alpha-tocopherol, beta-carotene cancer prevention study: effects of base-line characteristics and study compliance.

BACKGROUND: Experimental and epidemiologic investigations suggest that alpha-tocopherol (the most prevalent chemical form of vitamin E found in vegetable oils, seeds, grains, nuts, and other foods) and beta-carotene (a plant pigment and major precursor of vitamin A found in many yellow, orange, and dark-green, leafy vegetables and some fruit) might reduce the risk of cancer, particularly lung cancer. The initial findings of the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (ATBC Study) indicated, however, that lung cancer incidence was increased among participants who received beta-carotene as a supplement. Similar results were recently reported by the Beta-Carotene and Retinol Efficacy Trial (CARET), which tested a combination of beta-carotene and vitamin A. PURPOSE: We examined the effects of alpha-tocopherol and beta-carotene supplementation on the incidence of lung cancer across subgroups of participants in the ATBC Study defined by base-line characteristics (e.g., age, number of cigarettes smoked, dietary or serum vitamin status, and alcohol consumption), by study compliance, and in relation to clinical factors, such as disease stage and histologic type. Our primary purpose was to determine whether the pattern of intervention effects across subgroups could facilitate further interpretation of the main ATBC Study results and shed light on potential mechanisms of action and relevance to other populations. METHODS: A total of 29,133 men aged 50-69 years who smoked five or more cigarettes daily were randomly assigned to receive alpha-tocopherol (50 mg), beta-carotene (20 mg), alpha-tocopherol and beta-carotene, or a placebo daily for 5-8 years (median, 6.1 years). Data regarding smoking and other risk factors for lung cancer and dietary factors were obtained at study entry, along with measurements of serum levels of alpha-tocopherol and beta-carotene. Incident cases of lung cancer (n = 894) were identified through the Finnish Cancer Registry and death certificates. Each lung cancer diagnosis was independently confirmed, and histology or cytology was available for 94% of the cases. Intervention effects were evaluated by use of survival analysis and proportional hazards models. All P values were derived from two-sided statistical tests. RESULTS: No overall effect was observed for lung cancer from alpha-tocopherol supplementation (relative risk [RR] = 0.99; 95% confidence interval [CI] = 0.87-1.13; P = .86, logrank test). beta-Carotene supplementation was associated with increased lung cancer risk (RR = 1.16; 95% CI = 1.02-1.33; P = .02, logrank test). The beta-carotene effect appeared stronger, but not substantially different, in participants who smoked at least 20 cigarettes daily (RR = 1.25; 95% CI = 1.07-1.46) compared with those who smoked five to 19 cigarettes daily (RR = 0.97; 95% CI = 0.76-1.23) and in those with a higher alcohol intake (> or = 11 g of ethanol/day [just under one drink per day]; RR = 1.35; 95% CI = 1.01-1.81) compared with those with a lower intake (RR = 1.03; 95% CI = 0.85-1.24). CONCLUSIONS: Supplementation with alpha-tocopherol or beta-carotene does not prevent lung cancer in older men who smoke. beta-Carotene supplementation at pharmacologic levels may modestly increase lung cancer incidence in cigarette smokers, and this effect may be associated with heavier smoking and higher alcohol intake. IMPLICATIONS: While the most direct way to reduce lung cancer risk is not to smoke tobacco, smokers should avoid high-dose beta-carotene supplementation.

Age Factors↗
PubMed1995

[Tuberculosis control in Scandinavia].

Compared with the rest of the world, the situation regarding tuberculosis is favourable in the Nordic countries. In 1993, the incidence for persons born in respective country (per 100,000 of the population) was 4.1 in Denmark, 3.2 in Iceland and Sweden, 3.8 in Norway and 10.0 in Finland. The respective average figures for foreign-born residents were 6-14 times higher. Programmes for contending with tuberculosis have been uniform in the Nordic countries, with the exception of BCG (bacillus Calmette-Guérin) vaccination policy, though childhood tuberculosis is rare in the area. However, tuberculosis represents a manifest problem among the foreign-born population, first and foremost among the increasing number of refugees.

Adolescent↗
PubMed1995

Mycobacterial infections in Finland.

In Finland, the situation with regard to tuberculosis has been constantly improving during recent years, and the WHO criteria for a low incidence country (10/100,000) are presently satisfied. In contrast, the number of clinical specimens yielding atypical mycobacteria by isolation has rapidly increased. Organisms belonging in Mycobaterium avium-intracellulare complex dominate among the isolated species.

Adolescent↗
PubMed1994

Prevalence of asthma in elderly Finns.

There is uncertainty about the prevalence of asthma even in countries in which extensive epidemiological surveys have been carried out and attention has been drawn to a probable increase in prevalence. A cross-sectional epidemiological survey of asthma in the population aged 64 years or over was carried out in the rural district of Lieto, Finland. All 1196 participants (488 men and 708 women, 93% of those eligible) were examined and individually assessed using a set of criteria for asthma. The prevalence of current asthma was 2.9% in the men and 3.8% in the women and it accounted for about 40% of the cumulative (life-time) prevalence of self-reported asthma. Current asthma was uncommon in men aged 75 years or over and no cases were found in men who smoked. Current asthma in women was associated with low social status, smoking and dusty working conditions in the past. The difference in prevalence between the men and women was greatest among the smokers, which may be due to a previous high mortality among elderly asthmatic men who had been smoking, or a lack of the typical characteristics of asthma in men with long histories of smoking. The prevalence of asthma was similar to that obtained earlier in Finland and elsewhere.

Adolescent↗
PubMed1994

A comparative study of dirithromycin and erythromycin in bacterial pneumonia.

Dirithromycin, a new once-daily macrolide, was studied in a multicentre, randomised, double-blind trial in community-acquired bacterial pneumonia. A total of 591 patients received either a single daily dose of dirithromycin, 500 mg, or erythromycin, 250 mg, four times daily. Clinical response rates were similar in both treatment groups (127 dirithromycin-treated and 118 erythromycin-treated patients): at the time of the final consultation, the clinical and bacteriological response rates for dirithromycin-treated patients were 94.5% and 93.0%, while for erythromycin-treated patients, they were 92.1% and 90.3%, respectively. The nature and frequency of treatment-emergent events were comparable. We conclude that dirithromycin, 500 mg, once daily, is safe and effective in the treatment of community-acquired bacterial pneumonia. The once daily dose is likely to improve compliance, making it preferable to erythromycin.

Adolescent↗
PubMed1994

Prevalence of chronic obstructive pulmonary disease in elderly Finns.

The prevalence of chronic obstructive pulmonary disease (COPD) in the elderly is poorly known. The aim of this study was to determine the prevalence of COPD and to analyse the factors associated with it in an elderly Finnish population. The population consisted of persons resident in Lieto, Finland, born in or before 1926. One thousand one hundred and ninety-six individuals (488 men and 708 women, 93% of those eligible) participated in the survey, which was carried out in 1990-91 at the Lieto Health Centre. The methods included a nurse's interview and spirometry with a bronchodilator test. The participants were also clinically examined, and the number of subjects with COPD was determined using simple diagnostic criteria. Sixty-one men and 21 women with COPD were found. Thus the prevalence was 12.5% for the men and 3.0% for the women. In both sexes only about 2% of those who had never smoked suffered from COPD, but among the current smokers the prevalence was 35% for the men and 13% for the women. In a stratified analysis COPD was commonest among those with a low social status and histories of smoking and working in dusty occupations. In a majority the obstruction was only minimally reversible when tested with salbutamol inhalation. The study confirmed that the prevalence of COPD in the elderly with negative histories of smoking is low, and emphasizes the importance of reducing smoking as the only effective preventive measure.

Aged↗
PubMed1992

Later development of asthma in patients with a negative methacholine inhalation challenge examined for suspected asthma.

A negative methacholine inhalation challenge (MIC) in a patient with suspected bronchial asthma is generally considered to make this diagnosis unlikely. Nevertheless, the patient may later develop asthma. To estimate the proportion that eventually becomes asthmatic, a 10 year follow-up study was carried out on 334 consecutive MIC-negative patients aged 14-80 years. The development of asthma among these patients was assessed on the basis of entitlement to preferential refund from the cost of antiasthmatic therapy granted for them under national health insurance. During the follow-up 30 patients (9%) were granted the refund. There was no significant difference between men and women in this respect. Patients who developed asthma were somewhat older than those who did not. A family history of allergy, allergic rhinitis, and positive reactions to skin prick tests were significantly more common in patients with future asthma. These patients also had a lower mean forced expiratory volume in 1 sec (FEV1) (% of predicted) and a higher mean increase in PEF after an inhaled sympathomimetic than those remaining free from asthma. In multivariate analyses with a logistic model, 3 risk indicators proved independent predictors of future asthma: age, positive family history of allergy, and FEV1 (% of predicted).

Adolescent↗
PubMed1992

Sensitivity to PPD tuberculin and M. scrofulaceum sensitin in schoolchildren BCG vaccinated at birth.

OBJECTIVE: To determine the degree of and variation in sensitivity to PPD RT 23 tuberculin and M. scrofulaceum sensitin RS 95 at school age in children BCG vaccinated at birth. DESIGN: Double-testing by applying standard WHO Mantoux tests and inspecting BCG scars. SETTING AND PARTICIPANTS: Urban and rural schools in Southwest Finland, 1091 children aged 11-13 years. MAIN OUTCOME MEASURES: Size of tuberculin and sensitin indurations and BCG scar (mm). RESULTS: The mean size of tuberculin indurations was 7.2 mm, sensitin indurations 8.1 mm and BCG scars 7.9 mm. The reaction to sensitin was significantly larger than to tuberculin (95% confidence interval 0.58-1.10 mm) and the zero reactions to sensitin were fewer. Correlation between tuberculin and sensitin indurations was significant (r = 0.75, 95% confidence interval 0.72-0.77). There were induration greater than or equal to 15 mm to tuberculin in 16% and to sensitin in 14%. Sensitin indurations exceeded those of tuberculin by 4 mm or more in 14% of the children with at least 5 mm tuberculin indurations. CONCLUSIONS: High tuberculin sensitivity in healthy schoolchildren may be partially maintained by contact with environmental mycobacteria. Our data do not prove but very probably indicate that children have protective immunity. In view of the current incidence of tuberculosis in Finland and the likelihood that lymph node infections and sensitivity to environmental mycobacteria will increase, continued BCG vaccination at birth is recommended.

Adolescent↗
PubMed1992

Inhaled beclomethasone decreases serum osteocalcin in postmenopausal asthmatic women.

There are very few data as yet to quantify the effect of inhaled corticosteroids on bone metabolism, although the use of these drugs as a first-line treatment in bronchial asthma has widened. We determined the effect of three dose levels (200, 1000, 2000 micrograms/day, three weeks each) of inhaled beclomethasone on specific characteristics of bone metabolism in nine postmenopausal women with new asthma without any previous corticosteroid therapy. Significant decrease was noted in the mean serum morning osteocalcin concentration between the baseline and after nine weeks of beclomethasone (from 4.4 to 3.1 micrograms/l, p = 0.005). Significant increase in serum total and ionised calcium was found, although the parameters measuring bone resorption itself did not change. The results show that especially high-dose inhaled beclomethasone decreases serum osteocalcin in post-menopausal asthmatic women. Further studies are needed to assess the effects of inhaled beclomethasone, both on the ability of the osteoblasts to form bone matrix and on the density of bone during a longer treatment period on inhaled corticosteroids.

Administration, Inhalation↗
PubMed1992

Detection and identification of mycobacteria by amplification of a segment of the gene coding for the 32-kilodalton protein.

A polymerase chain reaction (PCR) assay for the rapid detection of mycobacterial DNA is described. Oligonucleotide primers, derived from the sequence of a gene coding for the 32-kDa antigen of Mycobacterium tuberculosis, amplified DNA from all 28 species of mycobacteria tested. All nonmycobacterial species tested were negative. An oligonucleotide probe hybridized to the PCR products of the strains belonging to the M. tuberculosis complex. This method could detect as little as 50 fg, as tested with purified M. tuberculosis DNA. By this amplification method, 127 sputum specimens were tested, with 7.9% of the specimens proving to be inhibitory in PCR. The sensitivity of detection by PCR compared with that by culture was 55.9%; when the inhibitory specimens were excluded, the sensitivity was 70.4%. The specificity of PCR combined with hybridization was 100%.

Bacterial Proteins↗
PubMed1992

Wegener's granulomatosis--treatment under revision?

A 44-year-old man with nasal and respiratory symptoms combined with positive serum antibodies to neutrophil cytoplasmic antigens (ANCA) suggestive of Wegener's granulomatosis was treated with antibacterial agents. Complete clinical response was achieved with co-trimoxazole, and the titer of ANCA declined. After a 12-month treatment period, the patient contracted fever and respiratory symptoms and fatigue again, and he had proteinuria and hematuria. After the institution of conventional treatment with oral prednisolone and cyclophosphamide, a favorable response was achieved. Wegener's-like granulomatosis is difficult to diagnose at its early stage, but the presence of ANCA may be helpful. We suggest that co-trimoxazole should be considered as a first-line treatment, under careful supervision, for young patients whose disease is limited to the respiratory organ.

Antibodies, Antineutrophil Cytoplasmic↗
PubMed1992

Indispensability of mediastinoscopy in intrathoracic tuberculosis.

An analysis of 33 patients with histologically confirmed intrathoracic tuberculous lymphadenopathy was made. Tuberculosis could have been diagnosed without mediastinoscopy only in 3 patients: 2 had positive bronchial cultures and 1 simultaneous cervical lymph node tuberculosis. Bacteriological confirmation is conclusive, but seldom possible. Mediastinoscopy provides the best method to obtain tissue samples, and consequently, it is still necessary in the diagnosis of intrathoracic tuberculous lymphadenitis.

Adolescent↗
PubMed1992

Periodic breathing imitating hyperventilation syndrome.

We report a male patient who developed an unusual periodic breathing. At presentation, the differential diagnosis at bedside between Cheyne-Stokes and primary hyperventilation syndrome was laborious, and the final verification was based on the result of capnography.

Cheyne-Stokes Respiration↗